The document provides an overview of adult social services in Barnet, including the challenges they face, the services they provide, who they support, how eligibility is determined, and their vision for the future which focuses on prevention, personalization, and partnerships.

1. Adult Social Services in Barnet Mathew Kendall Assistant Director Transformation and Resources

2. Presentation in three parts 1. Challenges and changes 2. Budget and way forward 3. Engagement and involvement Followed by questions and discussion

3. What is Adult Social Services? Through self-directed support , we aim to promote the independence of adults who need support, enabling them to live safely in their own homes where possible, and to encourage their participation in the community . We provide a range of specific services that help residents and carers in meeting these aims.

4. What services are provided? Day opportunities Home Care Meals at home Residential Care Nursing Care Respite Care Enablement Direct Payments Contingency Plans Telecare Equipment Advice and Information Equipment and Adaptations

5. Who do we support? Adult Social Services provide information and support for people over 16 with the most complex needs and people over 18 : with learning disabilities with mental health problems with physical and sensory impairments who have difficulties related to illness or old age with chronic or severe health problems including HIV/AIDS with drug and alcohol problems. We also provide information and support to carers . A carer is someone who looks after a friend or relative who is disabled, has mental health issues, is ill or is an older person.

6. Qualifying for a service We use guidelines set by the Government known as ‘ eligibility criteria ’, to determine if someone qualifies for help from Adult Social Services, based on their individual needs. These guidelines are used because we want to ensure: People in greatest need and most at risk receive help Everyone who asks for a service is dealt with fairly using the same guidelines Everyone understands the decisions we make and why. Once assessed, a persons eligible needs will be determined using the criteria contained in four bandings:

7. Bandings Critical - A persons circumstances mean that they are at immediate risk in their daily life You are unable to carry out any of your personal care routines. You are at significant risk of harm or neglect. Substantial - A persons circumstances mean that there is a risk of breakdown of the present situation You need support to carry out most of your personal care. Moderate - A persons circumstances identify moderate risk in their daily life You have some difficulties with your personal care but this does not put you at risk . Low - A persons circumstances identify minimal risk in their daily life You are able to carry out your personal care routine but with some difficulty Needs in the Moderate and Low band will not qualify for help from Barnet Adult Social Services.

8. How do we do this? By working in close partnership with the health service and the voluntary sector to help vulnerable people lead lives which are as full and independent as possible. By working directly with residents , service users and carers.

9. Safeguarding Adults Who is a ‘Vulnerable Adult’? A person of 18 years and over who is or may be : in need of Community Care Services by reason of mental health problems, disability, age or illness unable to take care of him/herself unable to protect him/herself against significant harm and exploitation

10. Barnet Safeguarding Adults Board Independent Chair Adult Social Services NHS Barnet Hospital Trusts Mental Health Trust Police Care Quality Commission Barnet Community Safety Group Safeguarding Children’s Board Barnet Voluntary Sector Barnet Carers Centre

11. The Boards work Annual review of the outcomes of the Board Analysis of the activity levels and information from referrals informing future direction Annual report produced – presented to Overview & Scrutiny Cross stakeholder work plan developed, focusing on strategic direction and ensuring that practice is effective Leadership of Safeguarding in Barnet Raising awareness Partnership work - the council, health providers and Police key to success

12. Poster used across the borough to raise awareness of adult abuse

13. Enablement Focus is on: Maximising skills to help an individual to live without assistance (such as getting up and dressed) or Resolving problems that were caused by a crisis (such as the extra support you might need when leaving hospital).

14. What happens after enablement? With the individual, we will review what difference the help has made and what further help, if any is needed. If further help is needed then an individual will be given a Personal Budget Questionnaire and Support Plan .

15. Enablement case study The Mental Health Enablement Programme provided by The Network supported Mrs L. to fulfil her dream. She had difficulty being independent of services, and needed support to become more socially included. Mrs L. is a talented fashion designer, so her key worker explored with her what support she would need to attend The London College of Fashion. With the knowledge gained from this course, Mrs L. decided she wanted to set up her own business. She is no longer using social care services and is in control of her life.

16. Personal Budget Questionnaire and Support Plan Aim 1) For an individual to think about what they need and the type of help they would like 2) To ensure the individual controls the planning process, as they understand their own circumstances the best 3) For Adult Social Services to work out whether an individual qualifies for a service under our criteria 4) Estimate a guide amount of money that will be available to pay for social care.

17. Personal Budgets improving quality of life Mrs S has advanced Multiple Sclerosis. She transferred from a traditional care package to a Personal Budget She had changed agencies several times because relationships with carers and their managers kept breaking down. She was depressed because she felt she had no control over her care and was unable to make any decisions. After receiving her Personal Budget, she was able to employ her own carers and her wishes about timings for her care and tasks to be completed were included in her Support Plan. With the help of a Personal Assistant, she has also started to improve her social situation and really take control of her life.

18. Some Statistics 14,000 people supported a year 7200 people supported via a service 1200 supported in residential and nursing care 4500 supported in the community 2000 carers supported 26 % Budget reduction 3.5% population growth between 2010 to 2013 6.7% growth for over-65s population Extra 700 people aged 85 or over (we currently provide services to 1 in 3 residents aged 85+) Rise in disability

19. Vision for Adult Social Care Capable Communities and Active Citizens Published November 2010

20. Policy Context for Vision Aligned to the Government’s values of: Freedom – shift in power from state to people and communities Fairness – through a lasting settlement to payment of social care Responsibility – social care is not solely the responsibility of the state

21. The Vision states Social care should enable ‘the greatest possible number of individuals to act reciprocally, giving and receiving services for the well-being of the whole community’ ‘ Social care is not the sole responsibility of the state. Communities and wider civil society must be set free to run innovative local schemes and build local networks of support.’

22. The 7 P’s of the vision Prevention – people and communities working together to maintain independence Personalisation – individuals taking control through Personal Budgets, preferably as Direct Payments Partnership – across public sector (eg. NHS, Housing), with individuals and providers Plurality – peoples diverse needs matched by diverse service provision and broad market Protection – sensible safeguards against the risk of abuse or neglect Productivity – local accountability to drive up productivity through publishing information about agreed quality outcomes People – workforce providing care with skill, compassion and imagination with the freedom and support to do so

23. Prevention Big Society theme of empowering individuals and communities – social care has a role in building community capacity Prevention is best achieved through community action – need to inspire neighbourhoods to look out for those who need support Carers are the first line of prevention – need to be properly identified and supported Prevention role of Councils will be enhanced by Public Health responsibilities Joint Strategic Needs Assessment to be key documents to support Health and Well-Being Boards take strong leadership on prevention Prevention services jointly with health , such as Telecare, re-enablement

24. Personalisation Securing the best outcomes for people as the focus Faster progress needs to be made to bring benefits to all. By April 2013, everyone with ongoing needs to have Personal Budget, preferably as a Direct Payment People in residential care should be able to exercise choice and control Personalisation will be key way to harness untapped potential of communities Good information, advice and advocacy is key and is a universal service

25. Plurality and Partnership Key role for Councils of market shaping with the NHS to achieve agreed outcomes away from block contracts to private providers, charities, social enterprises Partnership working includes working with children’s services on safeguarding and transitions Health Partnerships are key with Local Authorities playing lead role in communities to ensure services are coherent, integrated and responsive JSNAs to hold providers and commissioners to account through agreed local priorities underpinned by statutory duties to work together across GP consortia and Councils Joint Commissioning: pooled budgets and place based budgets to shift focus away from funding streams to people’s needs Merging and sharing of back office functions across Councils and NHS Commissioners

26. Protection State’s role to strike a balance – freedom and choice with risk and protection Support and encourage local communities to be eyes and ears of safeguarding – build on Neighbourhood Watch / local Health-watch role Local Government to be champion of safeguarding in local communities, ensuring people are clear on their roles and responsibilities. Government to work with the Law Commission in preparation for strengthening the law on safeguarding to ensure the right powers, duties and safeguards are in place.

27. Productivity, Quality & Innovation Finding new and innovative ways to deliver social care, maintain quality and work in more integrated way with NHS is key to CSR settlement. Key components to include: Effective rehabilitation and Long Term Condition management across health and social care Re-ablement Integrated crisis response Telecare to reduce spend on home and residential care

28. Productivity, Quality & Innovation Assisted Living developments supported by tele-health Sharing of back office costs to protect front line In-house services to be separated from commissioning Reduction in management costs of assessment and care management process, with more self assessment Councils to develop a local plan for reform to ensure making best use of available resources

29. People Principle of partnership and plurality will result in diverse workforce . Skills for Care and National Skills Academy for Social Care to publish new workforce strategy to support vision Personal Assistant strategy to be published in 2011 Greater focus on apprenticeships for professional roles and new care worker role in home and residential care Effective occupational health is key to driving down high sickness levels Social workers to play key role in community development to harness support of communities to look out for those in need. Invitations to establish Social work practice pilots – 2011

30. Conclusion “ This vision demonstrates the Government’s values of freedom, fairness and responsibility, shifting power from central to local, from state to citizen, from provider to people who use services…….. The spending review prioritised resources for social care and partnership working with the NHS…… This demonstrates the importance that the Government attaches to social care services…….. It is now up to councils, working with their local communities and those who already provide care as a carer, family member or neighbour to make a a reality of this vision”.